CASE-REPORT - SEVERE CHOLESTATIC JAUNDICE INDUCED BY EPSTEIN-BARR-VIRUS INFECTION IN THE ELDERLY

Infectious mononucleosis due to Epstein-Barr virus (EBV) is almost alw ays a self-limited disease, most commonly seen in young adults. Hepati tis is a well-recognized complication of EBV infection chat usually re solves spontaneously. Jaundice occasionally results from the unusual c omplication of autoimmune haemolytic anaemia rather than hepatitis. We report a 60-year-old man with severe cholestatic jaundice whose histo ry, liver histology and laboratory findings suggested EBV infection. H e also developed significant jaundice related to his hepatitis, but no t to autoimmune haemolysis, a situation that led to diagnostic delay. Costly diagnostic laboratory tests and invasive procedures were perfor med to rule out a malignant extrahepatic biliary obstruction. Physicia ns need to be aware of this complication and EBV infection should be i ncluded in the differential diagnosis of cholestatic jaundice in the e lderly.